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Savings through enforcement

As a follow-up to what I posted the other day about Republican claims that illegals will get healthcare coverage because the healthcare reform bill does not include enforcement provisions to exclude them from buying health insurance through the exchange. As many of you know, Republicans claim that Obama lied about illegals not being covered because enforcement was left out. Here is an interesting article that I found on medicalnewstoday.com. It discussed the success of the legislation meant to keep undocumented folks from getting medicaid. It looks like one of the dumbest things we could have ever done, and now Republicans would like it expanded into the HCR bills.

It seems that the enforcement through the SAVE program excludes those who are eligible and in the end manages to increase costs, not decrease them. So, if this is true, that I wouldn't support adding these enforcement provisions any reform bill.

Medicaid Proof-of-Citizenship Rules Lead To Enrollment Decline Among U.S. Residents, Not Undocumented Immigrants

New Medicaid proof-of-citizenship rules have reduced the number of beneficiaries in many states, although most of those dropped from the rolls were eligible for the program but could not provide adequate documentation, according to a Government Accountability Office report released on Monday, CQ HealthBeat reports. The GAO report also found that the rules -- initially projected to save the federal government $50 million and state governments $40 million in fiscal year 2008 -- "are likely to cost federal taxpayers significantly more than they generate in savings" because of higher administrative costs (Carey, CQ HealthBeat, 7/24).

Under the law, individuals seeking care through Medicaid must show proof of U.S. citizenship, such as a birth certificate, passport or other form of identification. The law's intent is to prevent undocumented immigrants from claiming to be citizens in order to receive benefits provided only to legal U.S. residents (Kaiser Daily Health Policy Report, 6/18).

A GAO survey of 44 states showed that 22 states reported a decline in Medicaid enrollment since the rule took effect, while 12 states said enrollment has not changed and 10 did not know whether it decreased or not. According to the survey, a majority of states reporting enrollment drops attributed the declines to the exclusion of eligible beneficiaries.

State responses also indicated that federal officials underestimated the cost of implementing the new rules. GAO said that CMS officials "did not account for the increased administrative expenditures reported by the states, and the agency's estimated savings from ineligible, noncitizens no longer receiving benefits may be less than anticipated" (Freking, AP/San Francisco Chronicle, 7/24).

A separate analysis released on Tuesday by the majority staff of the House Committee on Oversight and Government Reform showed that in six states, for every $100 of federal money spent implementing the new documentation rules, the federal government saved 14 cents. In those six states, $8.3 million was spent to identify eight undocumented immigrants out of a total of 3.6 million Medicaid beneficiaries, for a savings of $11,048.

Think about the cost involved in checking documentation on the literally millions who could be shopping for insurance through an exchange. You could need a government department the size of the IRS. Stupid Stupid Stupid!

"For everyone to whom much is given, of him shall much be required." -- Luke 12:48

The GAO report also found that the rules -- initially projected to save the federal government $50 million and state governments $40 million in fiscal year 2008 -- "are likely to cost federal taxpayers significantly more than they generate in savings" because of higher administrative costs (Carey, CQ HealthBeat, 7/24).

You mean to tell me that you find this surprising? You might save a lot of money in states like California, Arizona, Texas, and Florida for example. But a federal program requires checking many tens or hundreds of million in every other state in the union. That seems really smart.

Ok, maybe I'd like to see all the data before an enforcement mechanism that will cost millions is forced into the bill, not because it's smart, but because makes people feel better knowing that those stinking illegals won't be taking advantage of us. After-all, isn't it best to make decisions based on emotion?

"For everyone to whom much is given, of him shall much be required." -- Luke 12:48